The role of multidetector computed tomography in predicting the site of gastroduodenal perforation.

OBJECTIVE: This study aims to evaluate the value of multidetector computed tomography (MDCT) in detecting the location of gastroduodenal perforation. PATIENTS AND METHODS: This cross-sectional descriptive study was conducted with 47 patients who underwent contrast-enhancing MDCT and were diagnosed with gastroduodenal perforation during surgery between July 2021 and June 2022. Radiologic findings included pneumoperitoneum (distribution and quantity) and analyzed the image findings for localizing the site of gastroduodenal perforation. RESULTS: Pneumoperitoneum was the most common finding [95.74% (45 out of 47 patients)]. Regarding air distribution, the sensitivity (Se) and negative predictive value (NPV) of abdominal free air and supramesocolic free air were the highest (100% for both). The accuracy (Acc) of supramesocolic free air was the highest (93.6%), followed by abdominal free air (89.4%). Subphrenic free air also had a high Acc value (89.4%), with Se, specificity (Sp), and positive predictive value (PPV) being 90%, 85,7%, and 97.3%, respectively. The Sp PPV of falciform ligament/ligamentum teres sign, and periportal free air were also high (100% for both). In contrast, retroperitoneal free air was valuable in determining retroperitoneal duodenal perforation with an Sp, Se of 100%, and Acc of 89.4%. The thickness of abdominal free air was ≥5.5 mm, suggesting gastroduodenal perforation with a Se, Sp, PPV, NPV, and Acc of 82.5%, 100%, 100%, 50%, and 85.1%, respectively. CONCLUSIONS: Subphrenic free air, periportal free air, falciform ligament sign, and the air above transverse mesocolon were correlated to gastric and duodenal bulb perforation. Retroperitoneal air indicates the perforation at the retroperitoneal duodenum. The thickness of abdominal free air ≥5.5 mm indicates gastric and duodenal bulb perforation.

Gaseous environments modify physiology in the brewing yeast Saccharomyces cerevisiae during batch alcoholic fermentation.

AIMS: To investigate the impact of different gaseous atmospheres on different physiological parameters in the brewing yeast Saccharomyces cerevisiae BRAS291 during batch fermentation. METHODS AND RESULTS: Yeasts were cultivated on a defined medium with a continuous sparging of hydrogen, helium and oxygen or without gas, permitting to obtain three values of external redox. High differences were observed concerning viable cell number, size and metabolites produced during the cultures. The ethanol yields were diminished whereas glycerol, succinate, acetoin, acetate and acetaldehyde yields were enhanced significantly. Moreover, we observed major changes in the intracellular NADH/NAD(+) and GSH/GSSG ratio. CONCLUSIONS: The use of gas led to drastic changes in the cell size, primary energy metabolism and internal redox balance and E(h). These changes were different depending on the gas applied throughout the culture. SIGNIFICANCE AND IMPACT OF THE STUDY: For the first time, our study describes the influence of various gases on the physiology of the brewing yeast S. cerevisiae. These influences concern mainly yeast growth, cell structure, carbon and redox metabolisms. This work may have important implications in alcohol-related industries, where different strategies are currently developed to control better the production of metabolites with a particular attention to glycerol and ethanol.

[The impact of mental disorders on quality of life perceived by patients discharged from a security psychiatric hospital]. / Impact des troubles mentaux sur la qualité de vie perçue par des patients issus d'un hôpital psychiatrique sécuritaire.

AIM OF STUDY: This study assesses the impact of major mental and personality disorders on the quality of life perceived by a Belgian adult male population in a forensic hospital. METHOD.- POPULATION: Population included 72 male patients (mean age=41.00; S.D.=9.73) from a security hospital in Belgium. The evaluations were collected between March 2002 and June 2004. INSTRUMENTS: We used the World Health Organization Quality Of Life-brief (WHOQOL-brief, 22). The WHOQOL-brief was developed from the larger WHOQOL-100 data sets, forwarded from fifteen international field WHOQOL centers coordinated by the Geneva centre. The WHOQOL-brief is a generic and multidimensional self-report containing 26 items. It includes one item from each of the 24 facets of the WHOQOL-100, and two more items from the overall quality of life and general health facet. Like the WHOQOL-100, all items in the WHOQOL-brief are rated on a five-point scale. Four types of scales assess the: intensity (not at all-extremely), capacity (not at all-completely), frequency (never-always) and evaluation (very dissatisfied/very bad-very satisfied/very good). While the initial conceptual framework for the WHOQOL-100 offered six domains, WHOQOL-brief is composed of four factors: (a) physical health; (b) psychological health; (c) social relations and; (d) environment. Saloppé and Pham [Saloppé X., Pham Th. Validation du WHOQOL-bref en hôpital psychiatrique sécuritaire. A paraître dans Forensic] showed that the WHOQOL-brief fulfils the psychometric qualities to be used in the evaluation of patients interned in a forensic hospital. We used the diagnostic interview schedule screening interview (DISSI, 44) to evaluate major mental disorders and the structured clinical interview for DSM-IV axis II disorders (SCID II, 19) to evaluate personality disorders. PROCEDURE: The aim of this research was to evaluate the quality of life perceived by the forensic patients. It is essential that the instructions clearly indicate this direction so as to avoid patients evoking their quality of life in another environmental context. It is thus specified that the patient must answer the questionnaire referring to the institution's unit in which he was hospitalized at the time of the evaluation. DATA ANALYSIS: Initially, a descriptive analysis starting from the transformed scores is presented. In order to evaluate the impact of the mental disorders and the effect of the comorbidity on the quality of life perceived by the patients, in the second phase, we performed average comparisons using Mann Whitney's U-test. The data were analysed using the statistical package for social sciences (SPSS, 52), version 11.0. RESULTS: The forensic inpatients revealed a mean total score of 59.76 (S.D.=13.60) out of 120 on the WHOQOL-brief. The comparisons between the WHOQOL-brief factors suggested that the participants claimed to have better physical than psychological health (W=5.76, P<0.0001), environment (W=6.68, P<0.0001) and social relations (W=6.85, P<0.0001). Major mental disorders did not influence the perceived quality of life of the patients. However, the perception of their quality of life varied significantly in the case of personality disorders. Indeed, the patients with a narcissistic personality claimed to have better global quality of life than the other patients (U=120.00, P=0.005). They claimed to have better physical health, social relations and environment than those without this disorder (U=113.50, P=0.004 and U=136, P=0.011; U=159, P=0.034). Patients with an antisocial personality presented significantly higher scores on the WHOQOL-brief than those without this disorder in the social relations and physical health domains (U=445.50, P=0.020 and U=468.50, P=0.043). The diagnostic comorbidity had no impact on the quality of life of the patients. The lack of sufficient patients in the disorders groups may have contributed to this absence of result. CONCLUSION: The results of this study encourage us to further consider personality disorders associated or not with major mental disorders. This study reinforces the idea that to apprehend the quality of life of the forensic population is a fundamental element of their treatment.

[Evaluation of the HCR-20 Violence Risk Assessment Scheme in a Belgian forensic population]. / Evaluation de l'échelle de risque et de gestion de violence HCR-20 dans un hôpital sécuritaire psychiatrique belge.

Violence risk assessment constitutes a major concern in forensic psychiatry, psychology and related fields. Numerous instruments like the Hare Psychopathy Checklist (PCL-R, Hare, 1991) and the Violence Risk Appraisal Guide (VRAG) have been developed in the aim of improving precision in the prediction of violence. This study assesses the reliability index of the HCR-20 Violence Risk Assessment Scheme and evaluates its relationship with the PCL-R the Buss and Perry's self-report Aggression Questionnaire (AQ) and the type of offenses officially registered. All participants (n=86) are male adult offenders detained in a Belgian high-security forensic hospital. The mean IQ and age were respectively, 81,03 and 36,71. Items common to these instruments were omitted in order to avoid a circular effect. Results showed that the HCR-20 was significantly related to the PCL-R: the historical factor was strongly correlated to the PCL-R factor 2 while the clinical factor was strongly correlated to the PCL-R factor 1. The HCR-20 was significantly related to the AQ: the historical factor was strongly correlated to the AQ Physical Aggression factor and to the Anger factor. As regards to the HCR-20 relations with offenses, its Historical factor was related to both violent (assault and battery, robbery) and non-violent offenses (drug offenses, theft). Finally, the HCR-20 was also positively related to "instrumental" and rather premeditated homicide but negatively related to psychotic homicide. The overall findings are congruent with -published data on the convergent validity of the HCR-20.